• Clarissa Wei Shuen Cheong, Joy Xin Yi Au, Ming Yann Lim, Ernest Weizhong Fu, Hao Li, and Jereme Yijin Gan.
• Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
• Ann Acad Med Singap. 2022 Feb 1; 51 (2): 101108101-108.

IntroductionTo date, there have only been 2 systematic reviews, and 1 systematic review and meta-analysis on high-intensity focused ultrasound (HIFU) for benign thyroid nodules. The present systematic review and meta-analysis seeks to evaluate the efficacy and safety of HIFU in the treatment of benign thyroid nodules.MethodsPubmed, Embase and Cochrane databases were searched for relevant studies from 1990 to 2021. Nine studies were included in the systematic review and 6 in the meta-analysis. Pooled volume reduction rates (VRRs) at 3, 6 and 24 months after HIFU were assessed.ResultsThis systematic review and meta-analysis showed that pooled VRRs at 3, 6, and 24 months after HIFU were 42.14 (95% confidence interval [CI] 28.66-55.62, I2=91%), 53.51 (95% CI 36.78-70.25, I2=97%) and 46.89 (95% CI 18.87-74.92, I2=99%), respectively. There was significant heterogeneity in the pooled VRRs at 3, 6 and 24 months after HIFU. No studies recorded complete disappearance of the nodules. Common side effects included pain, skin changes and oedema. There were no major complications except for transient vocal cord paralysis and voice hoarseness (0.014%) and transient Horner syndrome (0.5%).ConclusionHIFU may be an effective and safe alternative treatment modality for benign thyroid nodules. Larger clinical trials with longer follow-up are needed to evaluate the effectiveness of HIFU in treating benign thyroid nodules.

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